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Journal of Translational Medicine
Published in: Journal of Translational Medicine 1/2021

01-12-2021 | Biomarkers | Research

The role of transcriptomic biomarkers of endometrial receptivity in personalized embryo transfer for patients with repeated implantation failure

Authors: Aihua He, Yangyun Zou, Cheng Wan, Jing Zhao, Qiong Zhang, Zhongyuan Yao, Fen Tian, Hong Wu, Xi Huang, Jing Fu, Chunxu Hu, Yue Sun, Lan Xiao, Tianli Yang, Zhaojuan Hou, Xin Dong, Sijia Lu, Yanping Li

Published in: Journal of Translational Medicine | Issue 1/2021

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Abstract

Background

Window of implantation (WOI) displacement is one of the endometrial origins of embryo implantation failure, especially repeated implantation failure (RIF). An accurate prediction tool for endometrial receptivity (ER) is extraordinarily needed to precisely guide successful embryo implantation. We aimed to establish an RNA-Seq-based endometrial receptivity test (rsERT) tool using transcriptomic biomarkers and to evaluate the benefit of personalized embryo transfer (pET) guided by this tool in patients with RIF.

Methods

This was a two-phase strategy comprising tool establishment with retrospective data and benefit evaluation with a prospective, nonrandomized controlled trial. In the first phase, rsERT was established by sequencing and analyzing the RNA of endometrial tissues from 50 IVF patients with normal WOI timing. In the second phase, 142 patients with RIF were recruited and grouped by patient self-selection (experimental group, n = 56; control group, n = 86). pET guided by rsERT was performed in the experimental group and conventional ET in the control group.

Results

The rsERT, comprising 175 biomarker genes, showed an average accuracy of 98.4% by using tenfold cross-validation. The intrauterine pregnancy rate (IPR) of the experimental group (50.0%) was significantly improved compared to that (23.7%) of the control group (RR, 2.107; 95% CI 1.159 to 3.830; P = 0.017) when transferring day-3 embryos. Although not significantly different, the IPR of the experimental group (63.6%) was still 20 percentage points higher than that (40.7%) of the control group (RR, 1.562; 95% CI 0.898 to 2.718; P = 0.111) when transferring blastocysts.

Conclusions

The rsERT was developed to accurately predict the WOI period and significantly improve the pregnancy outcomes of patients with RIF, indicating the clinical potential of rsERT-guided pET.
Trial registration Chinese Clinical Trial Registry: ChiCTR-DDD-17013375. Registered 14 November 2017, http://​www.​chictr.​org.​cn/​index.​aspx
Appendix
Available only for authorised users
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Metadata
Title
The role of transcriptomic biomarkers of endometrial receptivity in personalized embryo transfer for patients with repeated implantation failure
Authors
Aihua He
Yangyun Zou
Cheng Wan
Jing Zhao
Qiong Zhang
Zhongyuan Yao
Fen Tian
Hong Wu
Xi Huang
Jing Fu
Chunxu Hu
Yue Sun
Lan Xiao
Tianli Yang
Zhaojuan Hou
Xin Dong
Sijia Lu
Yanping Li
Publication date
01-12-2021
Publisher
BioMed Central
Keyword
Biomarkers
Published in
Journal of Translational Medicine / Issue 1/2021
Electronic ISSN: 1479-5876
DOI
https://doi.org/10.1186/s12967-021-02837-y

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